Procedures – Safety Engineering vs Social Care

As you may know, my fiance, John, who’s also autistic, works as a safety engineer. An inspector, if you prefer. That means he checks if people in his field follow safety procedures.

The last two days we had this conversation about how procedures are approached in his field and in social care. I edited it a bit for you.

John: 
First of all you look at whether the procedures are being followed. Then you look at any event or incident reports, examples of when things went wrong. If the procedures are not being followed the next question is are the people doing something that is better than what the procedure says? If so, raise enforcement for them to update the procedures to reflect what they do. If not? Then they made a mistake and it needs to be pointed out that the procedures must be followed and you might want to do a follow up investigation on training.
By looking at incident reports, you can identify why things went wrong. Was someone doing the wrong thing? In that case, it is a training issue. Were they following the procedure? In that case, the procedure is wrong and needs to be looked at.

John: From my perspective, it should not matter whether someone is ethnic minority or not when it comes to training.

Me: but the British are very skilled at twisting procedures in a certain way.

John: Well, again from my perspective, if procedures are twisted in any way, regardless of who does it, that would be picked up in a regulatory inspection. Makes no difference how or who or their background, if the procedures are not followed, are the procedures correct and if so, why are they not followed? Either change the procedures or focus on training and making sure they are followed.

Me: It doesn’t work like that here at all.
For example we had only 2h to give meds. If for any reason someone not got theirs or there was a tablet found on the floor, and you knew what it was, you couldn’t administer again but you had to fill in a form and call 111.
Even if it was just vitamin D.

John: That to me suggests then the procedure might need to be looked at. That said, I do not know what the regulations (or laws, they can be considered as laws) are in that area. The example you gave, is that a company procedure or a law they have to follow?

Me: I believe it’s just a company procedure. And because CQC doesn’t have time to assess the actual life in care homes, they look at procedures instead.
Therefore it pays to have strict procedures, even if barely anyone follows them.

J: Okay, in that case I would suggest that potentially the company procedure might need to be looked at. If we inspected that, we would ask about various scenarios and what they do, test the procedure and examine it. If no one follows them then they are not working.

Me: That’s not how this is being done in social care. In here, if you say that people don’t follow procedures because they’re nonsense, the response will be: but we can’t change them because it will look like we’re only doing it to make things easier for us.

John: It isn’t that the procedures are nonsense, just that they can be improved or don’t necessarily reflect what staff actually do.

Me: Possibly my ongoing work will get things improved in this area, however, it may not last for very long. Everyone will quickly go back to what they used to do.
That’s just how care system works. And residents are unaware of any of that so it doesn’t stress them out.
Also not following procedures in a very strict way doesn’t cause accidents as such so it kind of doesn’t matter. Procedures are for CQC, because CQC rates homes based on them.

Final words from me: perhaps there’s nothing too bad in this approach. But maybe it takes too much time for managers to work out the best procedures ever and the time would be better spent somewhere else? Also, what comes to my mind is that for people from different cultures it may be difficult to work out what principles The British use to twist things and as a result they identify their environment as hostile.

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